摘要
目的:探讨针药复合麻醉在肺切除术中的抗应激作用。方法:将48例行肺切除手术的患者随机分为常规麻醉组、针复2 Hz组、针复2 Hz/100 Hz组、针复100 Hz组,每组12例。针药复合组选取双侧后溪、支沟、内关、合谷电针诱导30 min。针麻诱导后全麻诱导。观察各组术中麻醉追加药量、血浆皮质醇及肾上腺素变化,术后拔管前5 min及拔管时的心率、收缩压。结果:针复2 Hz组、针复2 Hz/100 Hz组、针复100 Hz组丙泊酚追加用量均少于常规麻醉组(P<0.01);针复2 Hz组、针复100 Hz组的芬太尼追加用量少于常规麻醉组(P<0.05);针复2 Hz/100 Hz组、针复100 Hz组拔管时的心率较常规麻醉组慢(P<0.01);针复2 Hz/100 Hz组、针复100 Hz组拔管时的收缩压低于常规麻醉组(P<0.05,P<0.01);各组间血浆皮质醇和肾上腺素含量比较,差异均无统计学意义(P>0.05)。结论:针药复合麻醉可减少麻醉用量,并控制术中的应激反应。术前施以2 Hz/100 Hz或100 Hz针麻诱导能有效抑制气管拔管时的心血管反应。
Objective To observe the anti-stress effect of acupuncture-assisted anesthesia in patients undergoing pulmonary lobectomy.Methods A randomized,controlled,single-blind clinical trial was conducted in the present study.A total of 48 patients undergoing pulmonary lobectomy were randomized into regular general anesthesia（RGA）,general anesthesia combined with 2 Hz electroacupuncture（EA）（GA＋2 Hz-EA）,general anesthesia combined with 2 Hz/100 Hz EA（GA＋2 Hz/100 Hz-EA）,and GA＋100 Hz-EA groups（n=12）.EA（1-3 mA） was applied to bilateral Houxi（SI 3）,Zhigou（SJ 6）,Neiguan（PC 6） and Hegu（LI 4） for 30 min,followed by general anesthesia with midazolam（0.05 mg/kg）,fentanyl（5 μg/kg）,propofol（2 mg/kg）,and vecuronium（0.1 mg/kg）.The dosages of the anesthetics,heart rate（HR）,systolic blood pressure（SBP）,and bispectral index（BIS）of electroencephalogram during general anesthesia were recorded.Plasma adrenaline and cortisol concentrations were assayed by radioimmunoassay.Results In comparison with the RGA group,the dosages of supplementary propofol and fentanyl in both GA＋2 Hz-EA and GA＋100 Hz-EA groups,and that of propofol in the GA＋2 Hz/100 Hz-EA group were decreased significantly（P0.05,P0.01）.Compared to the RGA group,both HR and SBP values during trachea extubation in the GA＋2 Hz/100 Hz-EA and GA＋100 Hz-EA groups were significantly lower（P0.01,P0.05）.No significant differences were found between the GA＋2 Hz/100 Hz-EA and RGA groups in the supplementary dose of fentanyl,between the GA＋2 Hz-EA and RGA groups in HR and SBP values during trachea extubation,among the 4 groups in HR and SBP values before trachea extubation and in plasma adrenaline and cortisol levels（P0.05）.Conclusion Acupuncture-assisted anesthesia can decrease the dosage of general anesthetics,and effectively restrain cardiovascular stress reaction during trachea extubation in pulmonary lobectomy patients.
出处
《针刺研究》
CAS
CSCD
北大核心
2011年第5期361-365,共5页
Acupuncture Research
基金
国家重点基础研究发展计划("973"计划)项目(2007CB512507)
上海市中医优势特色专科
国家中医药管理局"十一五"重点专病专科(09J1X1LL17B120)
关键词
针药复合麻醉
肺切除术
应激反应
常规麻醉
Acupuncture-assisted anesthesia
Pulmonary lobectomy
Stress reaction
Regular general anesthesia
作者简介
傅国强（1959-），男，副主任医师，研究方向：针药复合麻醉及针刺对手术中免疫调节的影响。E-mail：fuguoqiang201010@hotmail．com
通讯作者：沈卫东（1967-），男，教授。E-mail：shenweidong1018@hotmail．com
